Archives for October 2018

This pragmatic cluster randomized controlled trial will enhance our knowledge on the clinical impact of diabetes risk scores for the first time in the real-life primary health care setting (BMC Endocrine Disorders)

Among a large cohort of adults who underwent RYGB surgery, weight regain quantified as percentage of maximum weight lost performed better for association with most clinical outcomes than the alternatives examined. These findings may inform standardizing the measurement of weight regain in studies of bariatric surgery(JAMA)

In type 2 diabetics, IGC was associated with a reduction in the risk for LEA. After 3.7 years of IGC there was an enduring protective effect against LEA. Improved glycemic control was a strong predictor of decreased risk for subsequent LEA. This study suggests that tight glycemic control, even over a short time period, has potential to reduce risk of limb loss (Journal of the American College of Surgeons)

The findings from this large nationwide cohort indicate higher mortality attributable to suicide, alcohol-related causes and accidents among diabetic patients than among the non-diabetic population. The results emphasize the importance of effective psychosocial interventions among high-risk diabetic patients (EJE)

The dual GIP and GLP-1 receptor agonist, LY3298176, showed significantly better efficacy with regard to glucose control and weight loss than did dulaglutide, with an acceptable safety and tolerability profile. Combined GIP and GLP-1 receptor stimulation might offer a new therapeutic option in the treatment of type 2 diabetes (The Lancet)

GV is more strongly associated with DR in type 2 diabetes than in LADA, suggesting that different glucose‐lowering strategies should be adopted for these two types of diabetes (Journal of Diabetes Investigation)

Apart from blood pressure outcomes, there was no evidence that intensive interventions improve or worsen HbA1c, total cholesterol, LDL, triglycerides, urinary albumin excretion rate, risk of cardiovascular or mortality outcomes in people with type 2 diabetes and microalbuminuria (Diabetes Research and Clinical Practice)

The results suggest that diabetic nephropathy is closely associated with the development of DPN in T2DM patients and that UAER and disease duration can be used as warning indicators of DPN progression (Diabetes Therapy)

In conclusion, optimal glucose target levels and treatment regimens in this setting of patients are still under debate. Future studies on intensive glucose control must be developed to reduce both glucose variability and risk of hypoglycemia, thus achieving an optimal blood glucose concentration in critically ill patients, particularly in ACS (Journal of Diabetes Research)

In this post hoc analysis of patients with T2D and high cardiovascular risk, liraglutide reduced cardiovascular outcomes both in patients with a history of MI/stroke and in those with established atherosclerotic cardiovascular disease without MI/stroke. The cardiovascular effect appeared neutral in patients with cardiovascular risk factors alone (Circulation)

Lixisenatide reduces progression of UACR in macroalbuminuric patients, and is associated with a lower risk of new-onset macroalbuminuria after adjustment for baseline and on-trial HbA 1c and other traditional renal risk factors (The Lancet Diabetes & Endocrinology)

This analysis highlights the need for a coordinated and collaborative approach to patient management. Given the widespread use of DR screening programs that can be performed outside of an ophthalmology office, and the overall cost‐effectiveness of DR screening, the presence and severity of DR can act as a means of identifying patients at increased risk for micro‐ and macro‐vascular complications, enabling earlier detection, referral, and intervention with the aim of reducing morbidity and mortality among patients with diabetes (Diabetes, Obesity and Metabolism)

In the foreseeable future, we will probably witness a wider range of dietary interventions and more incretin-based medications used for restoring both gastric emptying and glycemic levels to nearly physiological levels (Journal of Diabetes Research)

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